First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Expert Rev Clin Pharmacol. 2023 Jul-Dec;16(11):1063-1072. doi: 10.1080/17512433.2023.2274536. Epub 2023 Nov 22.
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent disease, associated with obesity, type 2 diabetes mellitus and dyslipidemia, which can lead to liver cirrhosis and hepatocellular carcinoma in some patients. Apart from lifestyle modifications, which are the cornerstone for its management, several drugs are under evaluation, including glucagon-like peptide-1 receptor agonists (GLP-R1RAs). In this review, we summarized major clinical data concerning the effects of GLP-1RAs on NAFLD, trying to highlight existing knowledge and to elucidate areas of uncertainty, thus providing clues to potential clinical implications and research.
Selected clinical studies on GLP-R1As in NAFLD are presented in this narrative review.
There is evidence that treatment with GLP-R1As in NAFLD has beneficial effects on NAFLD, i.e. improvement in liver function tests and histological improvement in hepatic steatosis and inflammation, but not fibrosis. Further research is required toward the early use of GLP-R1Αs, i.e. in NAFLD patients without fibrosis to evaluate whether they may prevent the progression to fibrosis, or in patients with advanced disease in combination with other medications, which may have additive or even synergistic effects on NAFLD.
非酒精性脂肪性肝病(NAFLD)是一种高发疾病,与肥胖、2 型糖尿病和血脂异常有关,在某些患者中可导致肝硬化和肝细胞癌。除了生活方式改变(这是非酒精性脂肪性肝病管理的基石)外,还有几种药物正在评估中,包括胰高血糖素样肽-1 受体激动剂(GLP-1RAs)。在这篇综述中,我们总结了 GLP-1RAs 对 NAFLD 的主要临床数据,试图突出现有知识和阐明不确定领域,从而为潜在的临床意义和研究提供线索。
本文对 GLP-1RAs 在 NAFLD 中的临床研究进行了叙述性综述。
有证据表明,GLP-1RAs 治疗 NAFLD 对 NAFLD 有益,即改善肝功能试验和肝脂肪变性和炎症的组织学改善,但对纤维化无改善。需要进一步研究 GLP-1Αs 的早期应用,即在没有纤维化的 NAFLD 患者中评估它们是否可以预防纤维化进展,或在晚期疾病患者中联合使用其他药物,这可能对 NAFLD 具有相加甚至协同作用。